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CDC director on Ebola crisis: Why I am going to Africa

CDC disease detective Kelsey Mirkovic, just back from West Africa, tells of working to gain the confidence of village leaders and train community health workers to spread the word about how to avoid getting – and stop spreading – Ebola. “The community health workers are key in the effort to stop Ebola because they are working with people in their villages every day. But if they meet with resistance, it’s the village chief who can make the difference. “

An encounter in one village, resolved with the help of the chief, taught Kelsey valuable lessons in how to reach people and communicate more effectively. A grateful chief presented Kelsey with a symbolic gift of cocoa pods and a coffee plant. For her, the gift symbolized the important connection made and confidence gained with a trusted community leader.

Kelsey and her colleagues are fulfilling our promise to the people of West Africa, Americans, and the world that CDC is quickly ramping up its efforts to help bring the worst Ebola outbreak in history under control.

We want to do everything in our power to help stop this outbreak.
We will protect people around the world, including in the United States, by stopping Ebola at its source.

CDC has deployed a rotating group of more than 60 staff members to Guinea, Sierra Leone, Liberia, and Nigeria to fight Ebola’s spread. And hundreds more support the effort here at home.

I’ve asked all CDC staff to consider the contributions they can make to helping stop Ebola. Now I’m headed to Africa, too. I want to hear directly from people there what can be done better and faster, and see what more I can do to support the critical work going on at the front lines of the fight to stop the disease.

We must quickly identify the ongoing needs and determine how to leverage additional help as soon as possible to fight the outbreak at the source. We want to do everything in our power to help stop this outbreak. We will protect people around the world, including in the United States, by stopping Ebola at its source.

I’m so proud of CDC staff, including our Epidemic Intelligence Service (EIS) officers, who serve as the world’s first line of defense – our boots on the ground – to prevent, detect, and respond to disease outbreaks. These disease detectives are essential to improve global health security and keep Americans safe and healthy. They are public health heroes.

CDC can’t be everywhere. That’s why we focus on helping countries develop their own cadres of public health workers who can apply the core principles of public health: find the disease, isolate patients, trace and monitor any contacts, and stop the exposures.

EIS is a global model for training in applied epidemiology. Since the 1980s, we’ve helped 40 other countries develop similar training through our Field Epidemiology Training Program (FETP). Trainees and graduates of these programs find and stop hundreds of outbreaks a year, usually without CDC’s direct involvement, which is exactly the type of self-sufficient sustainability the program is intended to foster. In April, two current FETP associates and one graduate from FETP-Kenya went to Liberia to assist in the response to the West Africa Ebola outbreak.

I hope to help generate the will and resources to expand FETP training to all of West Africa, something the CDC Foundation has already received $2.5 million from the World Bank to start.

But countries need resources to stop an outbreak. They need an emergency operations center, a nation-wide laboratory system, and real-time information systems.

Last year I visited Uganda, where we have a demonstration project underway to build that specific infrastructure. The progress of this project was deeply impressive, and will always stay with me as one of the highest impact initiatives CDC has undertaken in my time as director.

Within a year, the Ugandans were able to establish a laboratory network for deadly diseases – including Ebola – covering most of the country, improve emergency operations, and greatly improve their ability to respond quickly to new and emerging disease threats.

The Ebola outbreak in West Africa is a tragic and painful reminder that global health security has a direct impact on the health of all of us here in the United States. Infectious diseases do not recognize borders. Uncontrolled disease anywhere is potentially a threat everywhere.

Improving global health security will protect Americans while boosting our international partnerships and increasing political and economic stability overseas.

The U.S. government’s Global Health Security Agenda was created to strengthen our national security by partnering with other nations to prevent, rapidly detect, and effectively respond to disease outbreaks. Over the next five years, the initiative will strengthen the health infrastructures of at least 30 partner countries with 4 billion people. CDC has requested an additional $45 million in next year’s federal budget to further expand this vital initiative.

When we invest the time and resources to help other countries protect their own people, we help protect Americans, too.

We can stop Ebola with traditional public health measures, although it won’t be easy and it won’t be immediate.

But working together with our U.S. and international partners and country leadership, we are fully engaged in the fight to do it, and to help develop the people, labs, and response systems that will prevent the next outbreak of Ebola or any other health threat.

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I have already forwarded this information to several governmental health departments in West Africa. There is research that suggest you can stop the the transcription and replication of the EBOLA virus. Here is a link from pubmed: http://www.ncbi.nlm.nih.gov/pubmed/?term=ebola+heme+oxygenase-1. Here is the second link: http://www.ncbi.nlm.nih.gov/pubmed/11023535. This is biological view does not even address the potential physical effects of pressure that could be beneficial. If this viable I would love to assist to run some chambers to help those affected in West Africa. I am a Fellowship Trained Hyperbaric Physician. I really think this is a viable supportive treatment and maybe more.

Thank you for your talents, training, commitment, rank, and empathy. I am honored to write to you -a 21st century hero. Thank you I am from MN concerned for the countries and health workers who face the Ebola virus day after day. I understand you are close to a possible vaccine. You are also sending/sent workers to isolate and teach.

There is a petition on We the People with 19,980 signatures with a request “Release experimental drug, Zmapp to Africa!” It mentions medical personnel who contracted disease in line of duty-and was directed to President Obama. I also had started a petition “Please open transport of Ebola drug, Zmapp to Africa.” I mentioned the 2 Americans who were helped by this drug, moral, humanitarian reasons …………..directed to Dr Margaret Chan of WHO and President Obama.

I didn’t know of CDC’s major involvement until now. I am writing to you with a question –is the US able to send over thousands of ZMapp and/or another experimental drug to help restrain this epidemic, while they are studying ebola for a vaccine? I feel there many people including our 250 health care workers that are infected right now, and waiting for a vaccine will not help them. Our two American workers were helped with this——–can we send it over or something over now? For the infected–the other option is their death—anything would be welcome and would also help increase their HOPE.

Thank you very much. I will keep you all in my thoughts and prayers. Thank you for reading this.

At this time, very few doses of ZMapp have been manufactured. The manufacturer has indicated that the available doses have already been distributed, so it cannot be purchased and is not available for general use. Even if we had more of this treatment available, the product is still in an experimental stage, and it is too early to know whether ZMapp is effective. The manufacturer of this experimental treatment continues to research and evaluate the product’s safety and effectiveness. It has not yet been tested in humans for safety or effectiveness and much more study is needed.

Also, there are currently no FDA approved vaccines for Ebola. The NIH’s National Institute of Allergy and Infectious Diseases is working on developing an Ebola vaccine. NIH recently announced they are expediting their work and are launching phase 1 clinical trials of an Ebola vaccine.

The most effective way to stop the current Ebola outbreak in West Africa is meticulous work in finding Ebola cases, isolating and caring for those patients, and tracing contacts to stop the chains of transmission. It means educating people about safe burial practices and having health care workers strictly follow infection control in hospitals. This is how all previous Ebola outbreaks have been stopped.

To eradicate the Ebola virus epidemic in most effective, efficient and affordable
method, one must know and understand innate immunity.
By activating the innate immunity in real time, one can stop this epidemic at once.

sir i’m a Physician from Bangladesh, and i want to serve in Africa because-I’m writing this with tears in my eyes. I’m writing this as because I believe firstly I’m a human being, then I’m a Bangladeshi that’s why I could not tame my emotions, and lastly I’m a Doctor with all of my limitations. I was just preparing myself for the first time as a government employee joining my first training program tomorrow On “Outbreak investigation focusing on Ebeola, MERS, H9N9 & Nipah Infection”. Though “Ebeola” is the prime health concern worldwide in mainstream media somehow I overlooked it. So at first I went through my undergrad textbook about Ebeola, found it’s a hemorrhagic fever like Dengue that struck my own living place Dhaka few years back. But I am just shocked when I peep into the internet. I come across some pictures, two nurses escorting an infected African man from an isolated house with his family staying a good 50 yards back, and obviously two nurses wearing fully protective head to toe suit and goggles and gloves. That picture told the story and solved the mystery previously I faced in the newspaper that people are dying in Mid-West Africa, no one touching even the corpse, the deadly sick people remain unattended. Yes again a deadly disease struck Africa, and yes till now it is familiar to me. You know why I’m still crying? I continued reading on this only for five minutes, some News sites and found most reliable article on “The Lancet”. I could not bear the stern truth about the reasons Why this Ebeola outbreak turned into Epidemic? Our world health authority was not concerned first at all, or I must say they did not had enough fund to take steps, it is also not new for me as I came from one of the poorest country. As I read further-“the health care workers get scared and walk off the job, nurses have gone on strike, in worst hit Sierra Leone an Ebeola ward with its 55 dying patient had only two doctors, no helping hand not even a cleaner, no syringe was sterile, patients drenched into there urine, stool and blood, no one to decontaminate them. Yes I am from Bangladesh, I faced some tough scenarios but after all this world leaders not even the media did not pay any heed till a Doctor named Sheikh Umar Khan, the chief Sierra Leonean physician, Virologist fighting against Ebeola died of Ebeola. Wikipedia wrote-“he had a habit of hugging the cured Ebeola patients that were leaving his ward, to lift their spirits. In an Interview before infected with Ebeola Dr Umar told that his this hugging would-“give them certificates so that by the time they return to their villages people will understand that they are no more suffering from the disease and they are free to interact with the population”. No I’m not emotional with his tragic death, what struck me again the first few lines from the article of ‘The Lancet”- “more than 130 health workers have died from Ebola. Even before the loss of lives, Liberia and Sierra Leone had only about 90 and 136 doctors, respectively”

Yes those people dying in Africa are human being like me, like us. And as A doctor I strongly believe doctors should be free of boundaries. Doctors should be call upon and respond from any corner of the world to stand against death toll. As an inhabitant of this world even form this part of the world where there is scarcity of Physicians, we should step forward. Before that I confess, again I confess without any hesitation most of the Doctors of our country in their early life passing hard times with there career, without payment training, lack of Safety in workplace and with all other adversity, there should be a planned approach from Govt. or personal to stand beside our brothers in Africa and other countries lagging behind for Basic health service needs. I’d like to conclude with some hope, Doctors from our country previously worked in Liberia, Sierra Leone as a part of UN peace keeping mission. I myself personally would like to serve

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